PubMed · 6543165
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S Ullman. 1984. Visual routines.. https://doi.org/10.1016/0010-0277(84)90023-4
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A 50-year-old woman with human T-lymphotropic virus type 1-associated myelopathy developed sudden loss of vision in her left eye. The patient had a relative afferent pupillary defect and a large central scotoma on visual field examination, but no abnormal findings were apparent upon slitlamp microscopy and funduscopic examination. A diagnosis of retrobulbar optic neuritis was made. We discuss the possible association of human T-lymphotropic virus type 1 infection.
Retrobulbar neuritis is a common clinical manifestation of multiple sclerosis. We evaluated and compared the results of visual field and fundus examinations, visual evoked response and nuclear magnetic resonance of the brain in 37 patients with the diagnosis of multiple sclerosis and retrobulbar neuritis. Diffuse, peripheral scotomas seemed to be the most often found scotomas on perimetry in these patients. In contrary, central scotomas formed just a little part of the visual field defects. Each threshold increasing of 0.10 log. units on perimetry was followed by increased latencies of 2.5 ms. Each other central scotoma on perimetry decreased the visual acuity of the patient for 1.6 lines on the Snellen chart. The central visual field examination without periphery in the patients with multiple sclerosis and retrobulbar neuritis seems to give false negative results.
The author presents application of visual evoked potentials and static perimetry in hysterical amblyopia, psychical blindness, malingerers, amblyopia, cortical blindness and visual acuity assessment in infants. The author emphasizes the influence of multiple factors on the results and interpretation of the examination.